The CPAP industry has experienced several years of ongoing obstacles. From Covid, to a huge manufacturer recall, to supply chain and microchip shortages – every facet of the industry has felt the negative impacts: patients, physicians, suppliers, and manufacturers.
However, the start of 2023 marked a new and much brighter outlook. Patients and customers that had been previously waiting for months to receive a new CPAP machine post-sleep apnea diagnosis are now getting access to the medical equipment they need within days. Physicians are no longer left wondering if their patients will be able to get timely treatment for sleep apnea. Manufacturers have ramped production to fill in the gap the large Philips recall created.
With that said, the previous two years brought to light some of the underlying issues that make the CPAP and Sleep Apnea space difficult to navigate. The inaccessibility of machines connected to cellular or Wi-Fi networks (SD cards only), allowing for machine usage reporting to be easily obtained, resulted in increased costs for DME providers and many patients not meeting insurance machine use compliance requirements simply because data was not easily accessible. Couple a more difficult path to obtain use requirement documentation via machines with insurance requirements of prior authorization for each ongoing month of rental of the machine, and many patients were left with no choice but to pay out of pocket or return their machines, thus leaving their sleep apnea untreated.
Finally, the Philips Respironics recall brought to light the vulnerability in having only two main CPAP machine manufacturers in the market. The recall catapulted the industry, the patients, the physicians, and the durable medical equipment providers into chaos. We simply did not have enough machines to treat our patients, and Philips Respironics’ inability to produce machines left a gaping hole for almost two years.
So why aren’t more manufacturers interested in putting machines into the market as a part of their offerings? The answer is simple: insurance reimbursement for CPAP machines is low, driving down the manufacturers margin when selling to providers; the cost to manufacture these machines and maintaining the software and cellular infrastructures required to provide timely and easily accessible usage data is costly. There is no real incentive for new manufacturers to enter the scene.
The CPAP industry needs to leverage the lessons learned over the past several years to work to decomplicate the insurance medical coverage guidelines and compliance requirements to remove barriers to access for patients. We need to really assess the challenges presented to us in the face of the recall and understand how vulnerable the industry is should microchip shortages or a large recall occur again in the future. Finally, we need to come together as an industry: physicians, patients, manufacturers, and durable medical equipment providers to voice these vulnerabilities to the entities that can help decomplicate the path for patients to receive appropriate treatment for sleep apnea.
